At AlohaCare, under the new QUEST Integration plan, Case Management is now referred to as Service Coordination. Service coordination is a covered benefit for those who have Special Health Care Needs (SHCNs) or receive Long-term Services and Supports (LTSS). Service Coordinators review, plan, and help members meet their health and support needs.

You can refer your patients to Service Coordination that you believe may benefit from these services by contacting AlohaCare.

AlohaCare offers programs that help members with certain medical problems. These programs help members self-manage their chronic disease or condition so they can be healthier and more active. AlohaCare has programs for the following conditions:

Coronary Artery Disease

Asthma

Diabetes

AlohaCare uses an array of data sources to identify members for these Disease Management Programs. Identified members are sent educational information about their condition and are directed to AlohaCare’s website for an array of other resources. Based on indicators of severity, members may receive periodic phone contact from AlohaCare for education and assistance.

AlohaCare’s educational information can be found at the Health and Wellness tab. Samples of these materials will be provided upon request.

The main goal of the Disease Management Programs is to support member self-management of the identified condition, thus enhancing healthy living and lowering the use of inpatient and emergency services.

Providers play an important role in our Disease Management efforts. Member engagement in DM is critical to improving health status. PCPs and specialists are encouraged to work collaboratively with the member and AlohaCare staff to develop a coordinated DM plan with interventions that best fit the severity of the member‘s condition and individual needs. AlohaCare‘s pharmacist may also assist when medications appear to be a problem for the member.

Practitioners are encouraged to refer members to the disease management program. Members who may benefit from the program include those who are experiencing difficulty with self-management of their underlying disease or condition. AlohaCare will contact members who are referred to the program. Members may opt out at any time.

Providers will periodically receive educational materials to remind them of clinical best practices related to DM.

Call us if you have questions about our Disease Management Program or if you would like to speak to a Disease Management Nurse or other staff member. Call Member Services at 973-0712 (Oahu) or toll-free at 1-877-973-0712. TTY users call 1-877-447-5990. Staff is available from 7:45 a.m. to 5:00 p.m., Monday through Friday.

Services for hearing impaired members are available. Please give us a call:

TTY: 1-877-447-5990

Monday through Friday, 7:45 a.m. to 5 p.m.

Our after-hours answering service is available to answer calls outside of our business hours. Calls made after-hours that need routine follow up will be returned the next business day.

Language Assistance

If you need help understanding your benefits or how to get care and services, please call us. When you call us, you can ask to talk to someone in the language you speak. AlohaCare offers free interpreter services for our members. If you need an interpreter, call Member Services at 973-0712 (Oahu) or toll-free at 1-877-973-0712. If you require assistance due to a hearing impairment, call 1-877-447-5990.